Brucoli Matteo, Boffano Paolo, Pezzana Andrea, Corio Chiara, Benech Arnaldo
Division of Maxillofacial Surgery, University Hospital "Maggiore della Carita", University of Eastern Piedmont, Novara, Italy.
Oral Maxillofac Surg. 2020 Jun;24(2):157-161. doi: 10.1007/s10006-020-00836-9. Epub 2020 Mar 9.
Maxillectomy following tumors or, more rarely, traumatic injuries may result in maxillary defects that may determine physical dysfunctions and functional impairment of speech and swallowing. The aim of our study was to present our experience in the management of post-maxillectomy patients by the use of obturator prostheses that were obtained by 3D digital casts via an intraoral scanner.
Patients with maxillary defects following maxillary and/or palatal resection or maxillary traumatic avulsion were selected for this clinical study between 2015 and 2018. Five to 6 months after surgery, a definitive obturator prosthesis was fabricated thanks to an intraoral scanner. The following parameters of clinical outcome were considered: the absence of fluid leakage, the recovery of phonation, the recovery of swallowing, and personal satisfaction.
Twenty-eight patients (20 males, 8 females) fulfilled the inclusion criteria and were included in the study. Most patients had a maxillary and/or palatal defect because of a malignant tumor. On the whole, 93% of patients reported a complete absence of fluid leakage between maxillary sinuses or nasal fossa and oral cavity; most patients reported a good or complete recovery of phonation and swallowing.
Digital technology for the fabrication of maxillary obturator prosthesis may be effective and useful. The reduced laboratory working time, the avoidance of the risk of aspiration of impression materials, and the overcome of the difficulties associated with whole tissue undercut impression are just some of the most important advantages that have been encountered thanks to this promising technology.
因肿瘤或更罕见的外伤导致的上颌骨切除术后可能会出现上颌骨缺损，这可能会导致身体功能障碍以及言语和吞咽功能受损。我们研究的目的是介绍我们通过使用经口腔内扫描仪获取的三维数字模型制作的阻塞器假体来管理上颌骨切除术后患者的经验。
选取2015年至2018年间因上颌骨和/或腭部切除或上颌骨外伤性撕脱而出现上颌骨缺损的患者进行这项临床研究。术后5至6个月，借助口腔内扫描仪制作最终的阻塞器假体。考虑以下临床结果参数：无液体渗漏、发声恢复、吞咽恢复以及个人满意度。
28名患者（20名男性，8名女性）符合纳入标准并被纳入研究。大多数患者因恶性肿瘤导致上颌骨和/或腭部缺损。总体而言，93%的患者报告上颌窦或鼻窝与口腔之间完全无液体渗漏；大多数患者报告发声和吞咽功能恢复良好或完全恢复。
用于制作上颌阻塞器假体的数字技术可能是有效且有用的。减少实验室工作时间、避免印模材料误吸风险以及克服与全组织倒凹印模相关的困难只是这项有前景的技术所带来的一些最重要的优势。
